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Episode 71 | Dr. Joel Kahn | The Plant-Based Solution

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In today’s show, you’ll discover…

• Research has linked plant-based diets to a decreased risk of cancer, heart disease, and high blood pressure…plus, it could prolong your life.

• Clarity about the dangers of high-fat diets, and how much fat is recommended for heart health

• Inflam-AGING…how specific types of protein accelerate the aging process  

• Sensible and specific tips on how to begin a plant-based diet if you’re a meat lover

Connect With Dr. Joel Kahn

Website | Books | Dr. Kahn’s Podcast | Instagram 

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Follow Along With The Transcript

Kathy Smith: Joel, welcome to the show.

Joel Kahn: With that guest list you just read off, the blog is there, Twitter’s there but just some bright minds. I’m very honored to join you. Thank you very much.

Kathy Smith: First of all, I’ve always wanted to assemble, on one stage, the supporters of all these different eating styles and have them debate one another to answer this question of what is the optimal diet for good health. Then it caught my attention when I saw that you were invited to have this debate at Google’s corporate headquarters with Dave Asprey, who is the creator of Bulletproof and Kip Anderson. It was amazing, because I thought, “I wish I would have been in that audience.” Tell me, what was the tone of the discussion and who won the debate?

Joel Kahn: I’ll just say, in general, these debates go back decades. I don’t know the history of every one, but Dr. Dean Ornish, one of the pioneers for sure of lifestyle medicine and plant-based science debated Dr. Atkins. At the time, there was no Internet. You can go look up the YouTubes. They’ve had 3,000 views now. This Google conversation that we had had 1 million views. I was recently on the Joe Rogan Experience and debated this question with Chris Kresser, and it’s had millions of views. So the interesting thing is how we can get this out, but the confusion and the disagreements haven’t gotten any smoother.

I met Dave Asprey about five or six years ago. He was an interesting guy then – not quite a wealthy and not quite as well known. He’s had a phenomenal business ride. I don’t agree with everything. So when I go into a setting like that – and even Google said to us, “Your goal is to educate our people. We’re going to beam this all over the world. Your goal isn’t to win. Let’s see if we can come up with something people can walk away from rather than just say, “They’re all confused and I’ll just have a cheeseburger tonight because it’s simpler.”

If anybody watches it, it’s on YouTube Google Talks, maybe late 2017. I stay pretty calm in these settings, because at the end of the day, if you’re a lover of keto, you’re not going to change your mind because I said something. If you’re a lover of plant-based, you’re not going to change because Dave Asprey said something.

Actually, I try and build bridges. Even I’ll bring it up to one more. I’m going, first time ever, a plant-based physician’s going to Paleo f(x), which is 8,000 screaming cavemen and cavewomen. I’m going to be on a panel, which is an agreement panel. It’s some people that, typically on the social media, we beat each other up, but we’re going to agree what has to change. I think what everybody agrees is less crap, more green. Even if you eat a Mediterranean, keto, paleo. Carnivore’s the weirdest movement. They don’t even eat green veggies. They just eat meat and sometimes cheese and eggs. It’s a crazy movement, but it is alive.

But we can agree when I specifically said, “Eat less crap, eat more fruits, vegetables, nuts, and seeds.” I think every health expert of any credibility would agree we can hold hands and sing Hakuna Matata, wouldn’t you Kathy? I really do believe that.

Kathy Smith: Yeah. It seems like loading up on processed foods – the cereals, the sodas, the white pastas – everybody agrees that’s a no-no for any diet plan.

Joel Kahn: Completely. And the science is there. I don’t want to talk only science but I watch what’s going on. So just this week, a huge international research study on diet and health and longevity that is funded by the Bill and Melinda Gates Foundation. It’s called Global Burden of Disease Study for about a decade.

They’ve been pumping out huge sophisticated studies. For example, high blood pressure is the number one killer worldwide, more than any other cause. High blood pressure leads to blindness, kidney failure, heart disease, stroke, aneurism rupture. That came out in the Global Burden of Disease. They published a study and people saw the headlines. Twenty percent of deaths worldwide – not just Park City, Detroit, and Los Angeles. Twenty percent of deaths worldwide are due to wrong nutrition patterns.

What were those nutrition patterns? Number one on the list was too much salt. Number two was too few whole grains. Number three, too few fruits. Number four, too few nuts and seeds. Number five was too few vegetables. Way down the list was too much garbage. The headlines weren’t totally inappropriate. More than bad food is the absence of good food. Fifteen percent of America smokes. Fifteen percent of America works out. Ninety-seven percent of America doesn’t eat enough fruits, vegetables, nuts, and seeds. We can talk about whole grains or not because that’s divisive. And I’d rather not be divisive. I’m pro whole grains. But lots of people out there believe they are Satan.

But it’s interesting. Just put in the good stuff. That’s not even asking you to change your diet. Get good stuff on your plate along with whatever you’re eating, and you just upgraded your diet according to this huge international study.

Kathy Smith: Yeah. And the good stuff, I think everybody again, agrees upon are those veggies – the colors of the rainbow – the greens, the reds, the purples. Veggies, lots of them. I think one of the other big debates in this movement though is about this macronutrient called fat. We have one side saying coconut oil and palm oil and saturated fat is fine and no problem. Then we have the other side saying, “We need to cut back on fats, and the fats that we eat need to be coming from avocados and nuts and seeds and olive oil.”

Before you answer that question, which I want to give you time for that, I just have a thought that I wanted about your last question. When you talk about how far back this movement goes – and this dates me – but I came out with my first product when Nathan Pritikin was launching the Pritikin diet in Santa Monica. This was the plant-based 10% fat that everybody was jumping on the bandwagon until Atkins came out.

You’re right, this has been cycling around over and over. And yet, I feel like fat is the place where I am still very confused. After you answer, I’m going to tell you why it’s near and dear to my heart.

Joel Kahn: I think Nathan Pritikin just came out with stuff a year ago. You’re very young and eternally lovely. But Nathan Pritikin happens to be somebody I study and is a real hero of mine. Fat – again, looking for more agreement than dissent. In general, the data has been, since the 1960s, that there are healthy diets high in fat and there are healthy diets low in fat. I’ll give you the two classic examples. Actually, there are three classic examples.

Study the portion of Japan called Okinawa, where until big food and fast food came in, the studies that are published is traditionally less than 10% of their calories in their ethnic diet was from fat calories. They have exceptional longevity during that life period, some of the top highest in the world. Sixty-five percent of their diet came from purple potatoes alone and 80% were complex carbohydrates. Never a donut, never a Pop Tart, never a seven-layer cake. It was garden food that was traditionally prepared. They didn’t eat much rice in Okinawa. They ate a lot of purple potatoes. That was a low-fat diet that worked perfectly for them.  

Then, there was the island of Crete. Forty percent of their calories came from fat, and yet, Crete is not officially in the blue zone, but it was part of the Mediterranean diet data with exceptional health and longevity, very little cancer and diabetes rates compared to the western world. Their fat calories are almost exclusively from very pure olive oil that came right off the trees in the gardens that they live amongst.

At the exact same time, Finland had a dietary pattern that was 40% fat. This is all well-documented. It was butter, it was sausage, it was cheese. The typical lumberjack sandwich was exactly that – bread, butter, cheese, sausage. They had the highest heart attack rate in the western world in 1968, 1969, and 1970 when Crete had among the lowest in the world with 40% calories from fat.

So we have to get more sophisticated. And the overwhelming bulk of the data is you can construct very healthy naturally low-fat diets. They’re likely going to be almost exclusively plant based. You can construct moderately high-fat diets of plant origin – olive oil, avocados, nuts, seeds, olives, traditional Mediterranean foods. And we’ll have a lot of data.

We can also construct very dangerous high-fat diets. I would put most versions of the ketogenic diet, if you look over the course of history, is in that camp and very concerning. Not for two weeks to get into a wedding dress, but for two years or 15 years or 20 years. Cancer takes a decade plus to develop and grow. Heart disease takes a decade plus. We didn’t hear of the keto diet 10 years ago, so nobody’s had the longevity in this, with few exceptions. There are a few people out there that have been doing this and put out Twitter pictures of 20 years ago. But they’re single individuals, not large studies.

So fat doesn’t have to be the enemy. I, as a cardiologist, I know my arteries are clean. I’ve done every test that a human can do. I’ve been plant based for 40 years. I think it’s paid off pretty well and with a family history of heart disease. But I will eat an avocado and olives and nuts and occasionally some olive oil. My concern is I was a chubby little boy growing up when my mother cooked traditional foods. My mother went to the Pritikin Center right about when you’re talking and totally changed diet, but my Bar Mitzvah suit was a husky, chubby Bar Mitzvah suit. I still have that zone set pretty high. I have to watch it.

There are 4,000 calories in a pound of olive oil and 100 calories in a pound of kale or spinach or bok choy. I eat largely whole plant-based foods because of calorie density and other advantages. Because they just naturally, I can fill my plate up and get far less calories than if I put the four tablespoons of olive oil and just added 500 calories for very little nutrition that none of which is essential. There’s nothing in olive oil that’s essential.

But if you can find good quality, extra virgin olive oil and you’re thin and you’re healthy, go for it. That’s my general response to a very good question.

Kathy Smith: The idea of how much weight you put on when you eat the fat is one side of it. The side that I have to be more concerned about since weight typically is not my issue. I don’t have that gene. But the gene that I have, and I’ve heard it loud and clear. My dad died of a heart attack when he was 42. My cholesterol levels, when I was 30, were like 200. That’s one of the reasons why I ended up not at the Pritikin Center. But the Pritikin Center had a lunch counter that anybody could go to. We would all go down there after our runs on the beach, and we would hit the Pritikin Center for lunch. It was always this idea of, as you just mentioned, plant-based, whole grains, minimal oil.

I want to tell you a story though. I shifted out of that a couple of times in my life. Once was maybe about a year ago when paleo and keto really came on the scene. It’s like oh, my gosh, you can eat instead of an egg white omelet, I’ll eat the whole egg. I’ll be having, especially as the ghees, the butters, these things, they’re not bad anymore. What happened is I started eating more of that and within about six months, my cholesterol levels went up about 80 points. I realized that I’m very sensitive to fats.

Now, I have a daughter who is 30 years old, who ran in the Olympics in 2016, and a very similar thing happened to her. She went on a high-fat type of program and her numbers went up about 100 points within about four or five months.

So talk to us about that. That’s the thing that I have to get really clear on, because we’re getting these mixed messages. I pass the potato chips that are cooked in coconut oil and I’m thinking, “But coconut oil is good for me now.” Talk to that a little bit and about the marketing side.

Joel Kahn: It’s really fascinating. Again, if you have a 30-year-old daughter, you must have had her when you were nine. Truly. I mean it. We’ve been together. This isn’t just Internet talk. I’ve been with you. You look wonderful.

It’s an interesting topic you bring up. We know that health people doing the ketogenic diet – even proponents of the ketogenic diet – we’ll say 25% to 30% are called hyper responders. Their cholesterol will shoot up like crazy with the high fat content of the ketogenic diet. So high, it might hit 400, 500, or 600 in your blood, which I essentially never see in my practice in Detroit in any situation other than somebody who just kind of laxadaisily adopted the ketogenic diet because they saw some PBS special on TV, never thought of checking their labs. I publish data on this, so it’s not just an observation. Anybody can Google it with my name. But people with 300 point rises in cholesterol, it’s 25% or 30%.

The problem is, a lot of the advocates on the Internet aren’t even mentioning getting repeat bloodwork. The classic is an orthopedic surgeon from Albuquerque who’s quite popular on social media, Shawn Baker, M.D.– he’s got a medical degree, not practicing right now, who adopted the carnivore diet for a year. He didn’t need to but just did it, went on the Joe Rogan Experience podcast on YouTube. When he was questioned, he said, “I didn’t do any bloodwork. I’m fine. I feel fine.”

When he finally was beat up – you’re an M.D. promoting this and you didn’t do your own bloodwork, his LDL cholesterol had gone up to 150. That’s not sky high, but that’s not optimal. He was prediabetic. His hemoglobin A1C was 6.3 and his testosterone was under 250 or so, which is rather concerning. This is a diet that began as a therapy of children with epilepsy. It was always monitored with careful assessments by medical doctors.

Yet every Tom, Dick, and Harry is doing it now. They have no idea what it’s doing to arteries. They have no idea what it’s doing to their blood levels. And one should be careful. If you’re doing it for 10 days because you’ve got a trip and you want to wear your bikini or your speedo, I wouldn’t be too concerned. Your numbers might go up, but they’re probably going to go up for short term. My friends on keto two years, three years, four years, five years will say that. You need to monitor it because it is an experiment.

Now, your family might have a gene, Kathy, that you can check in your blood. You don’t have to say it on air. It’s called APOE – like elephant. If you’ve inherited, you get two genes – mom and dad, and if you’ve even inherited one, or certainly if you’ve inherited two called APOE4, you cannot tolerate saturated fat diets with the same flexibility that people that inherit the more common E 33 inherit. It’s well-known. It’s in the medical literature. There’s a book out there called Eating to Your APOE Type. It’s not a common test in my practice. It’s a routine test.

But anyways, you may have that or other gut reasons that you just hyper absorb the saturated fats that you’re putting in. So it’s a good experiment you did. I wouldn’t do it again. When we’re done with this conversation, you just keep on talking and we’ll do a clinic visit with you.

But I will say when I describing Okinawa, Crete, Finland, the one body of data that’s absolutely, to me, sacrosanct is a few of the listeners might know they have heart disease. They’ve had bypass, they’ve had a stent. Maybe they’ve had a carotid surgery operation. They’ve got the real deal. The only data that diet impacts favorably is Mr. Pritikin – he was an engineer, not an M.D. – is Dr. Dean Ornish, a physician in San Francisco, is Dr. Caldwell Esselstyn, a physician at the Cleveland Clinic where adopting that naturally low-fat plant diet can wrest and reverse the worst killer of men and women in America. So I’m very specific about being very generous on diet topics for the general public.

But don’t cross the line and tell me ketogenic diet’s for heart patients. It’s immoral, it’s probably unethical, it could probably generate a lawsuit, because there’s nothing but harm in the literature.

Kathy Smith: I’m glad you’re sending that message out loud and clear. Let’s talk about these tests. I’ve heard you talk about this on other podcasts, and I think it’s interesting that we typically go in and get our bloodwork done and we get our cholesterol checked – our LDLs, our HDLs. But what are some of the tests – maybe mention a few of them – that we should be getting done – almost everybody – on a regular basis to understand where you are right now as far as even anti-aging markers?

Joel Kahn: If people have only one thing they can remember, you can identify if your heart– I’m going to assume you’re healthy, you’ve not had a heart attack, not had a stent, not had a bypass– nonetheless, the absence of symptoms is absolutely no reassurance that you aren’t going to have a heart attack in the next six months. Absence is absolutely no reassurance.

If anybody has any question, study the story of Kevin Smith, the actor/producer. Until the day he was going on stage and going to do his comedy routine at age 47 and just got cold and felt horrible, he had never had a warning. And that day, he almost died from a massive heart attack just like Bob Harper, the Biggest Loser. Typically, the day your heart attack starts is the first day, and it may be the day you die is the first day that you have the symptom.

So your doctor puts a stethoscope on your chest, your doctor takes your blood pressure, your doctor does some routine labs, pats you on the back. Your [inaudible 00:24:31] is high. He says, “Hey, everything looks good.” That’s all they’re allowed to do. They’re not allowed to order an electrocardiogram anymore under standard insurance policies.

This is what everybody wants to write down. Twenty years ago, in San Francisco and now every hospital in America of medium to large size, with a prescription, you can ask for a heart calcium CT scan. This is a 15-second test – heart calcium CT scan. Lie on a stretcher, hold your breath, in a CT scanner, not claustrophobic, go home, get a report. If the report says zero calcium, you have a party. Please just eat a big salad, not a cheeseburger. But you are winning the battle that kills more people than any other disease worldwide. It kills more people than all cancers combined worldwide.

If you come back– and there’s a number – 100, 400, 800 – it depends on your age – you’ve identified this process at a silent phase. Then you need phase two, which is the right labs. Of course, you need to find out are you smoking, what’s your weight, what’s your height, what’s your blood pressure, but what’s your cholesterol more importantly. There’s an advanced cholesterol panel called and LDL particle number. What’s your three-month blood sugar called hemoglobin A1c? What’s your inflammation – your high-sensitivity C-reactive protein? And maybe two more. What’s your homocysteine, a genetic marker of metabolism? And what’s your LP little a, a funny little three word – LP little a – a genetic cholesterol that can kill but is not on anybody’s routine panel.

So it’s really that two step. Find out if you’re young or old inside because the CT scan never lies. And there’s nothing better than finding out you’re a zero. Then do it again in 10 years. It’s the amount of radiation of a mammogram, a very respectful that it’s a radiation CT scan. But it’s very low and, often, I never repeat it in my patients. So it’s a one-time exposure. Number two, get blood tests a little bit better than average.

Kathy Smith: Okay. We talked about fat. The other big topic in these two camps – mainly the keto camp – is the protein. Where are you going to get your protein from? If you’re not eating your meat, your fish, your eggs, and everything else, you’re not getting your protein. Without protein, you can’t maintain your muscle mass, etc. Can you address that?

Joel Kahn: Absolutely. You mentioned that you’ve spoken with Dr. Valter Longo, so there is that classic statement that people belittle medical training with – that 50% of what you learned in medical school’s wrong, but we don’t know which 50%. We don’t know which part.

You can therefore become nihilistic and say, “Research and everything’s up for grabs.” Not everything’s up for grabs, but it’s true you have to have an open mind that we may relearn things.

We spent 20 years with people particularly in the fitness industry like you. Meat, chicken, maybe tilapia, protein, protein, protein. Of course, there has been the rise of many plant protein alternatives, some of which are real food like beans, peas, lentils, organic soy-based products and such and a lot of powders and a lot of bars and this huge concern.

When Dr. Valter Longo, esteemed worldwide famous professor at the University of Southern California and also at the Cancer Institute of Milan, analyzed data on humans in the United States and their protein content and their health and their longevity, he saw something very interesting. It actually was favorable to have a lower protein intake until you’re in your 70s when you start to worry about frailty, start to worry about falling and not having muscle mass to get up, and things like that.

But actually, the rate of heart disease, the rate of cancers, the rate of actual survival was better in people that ate a low-protein diet – with one asterisk. That was when he analyzed the data from the data base for animal-based proteins – mainly meats, chickens, foul, pork. When he analyzed it for fat protein, there was no harm in any phase in life. Eat all you want. You can have all the legumes in life you want. You can probably add in plant-based bars and powders all you want. Of course, those aren’t usually studied.

It’s interesting. There are the same 20 amino acids in a chickpea and in a soybean that there are in a porterhouse steak and in a chicken breast. But the percentages are different in terms of how they’re aligned. Methionine is more common in red meat than it is in plants, for example.

There’s also what it’s associated with. When you’re eating a soybean, you’re getting phytoestrogens and phytonutrients and vitamins and fiber. What you’re getting with the porterhouse steak is saturated fat and maybe the hormones and the antibiotics that were all used to create that animal and that animal’s contribution to our flush-faced meal.

Dr. Longo has rewritten the book on protein, and the question no longer is where to get your protein. It really should be where do you get your fiber? Because we are a nonprotein-deficient country and a very fiber-deficient country.

Fiber’s not in animal foods. Fiber’s only in plant foods. If you love your steak, your chicken, your fish, your burger and you’re listening to this, just make sure you eat salads and beans and peas and nuts and broccoli and cauliflower and apples and oranges, because they have fiber that will assist your normal cholesterol, your gut health – let the bacteria in your gut make healthy, little, short-chain fatty acids that favor your metabolism and keep your blood sugar down and such.

Again, it’s not so much you have to immediately take out what I would call “the bad foods”, but make sure you’re always stacking with a whole lot of the good foods which a [inaudible 00:30:21] after these studies that are fruits, whole grains, vegetables, nuts, and seeds is the top four or five along with reducing your salt.

Kathy Smith: Did I hear you mention that animal protein can cause age acceleration? There’s something in it that actually accelerates our aging?

Joel Kahn: Right. And that’s some well-known biochemistry. Again, I go back to Dr. Valter Longo. Anybody interested can read his book The Longevity Diet that came out in January 2018. It’s an amazing read, all based on very high-level peer-reviewed science.

But animal-based proteins, the amino acids in animal-based proteins, the mixture of them, activated pathway called mTOR – mechanistic target of rapamycin. But MTOR is a hot topic in aging. And you don’t want your MTOR pathway to be jacked up and on all the time. You want it to be low and off a lot of the time and cycle it on and off.

When you’re eating protein-based, amino-based foods of an animal constitution, you will rise in your MTOR activity, you’ll raise – including dairy now – an aging factor called insulin-like growth factor 1 – something we want as a kid when we’re growing. But we don’t want it jacked sky high all during our adult years, because it promotes cancer growth and aging.

Diets that lower IGF1 at least some of the time, which are going to be removing dairy and meats, diets that lower MTOR activity, which would be diets that are low in meat, at least some of the time, are going to promote healthier aging. I very much tell people to take a break. If you’re not willing to give up what’s called the reducetarian movement. Reduce the meats. Do some meatless days. Find some plant-based meals. It’s a big movement right now called the reducetarian. It’s a weird word to say, but it gets to the point that this doesn’t have to be so threatening. It can be gradual movements away from a heavy meat and potato diet that some of us grew up with and some of our parents ate ethnically.

Kathy Smith: I like that you’re saying that. It’s funny; it’s less difficult now to be a vegetarian or vegan. Last week, I read that Burger King just launched a vegetarian-friendly burger that supposedly tastes like meat. It’s called the impossible burger. I hear they’re testing it in Saint Louis right now. I tried the impossible burger when they had them at Sundance this last year. So it’s starting to filter into all different segments of the marketplace.

But let’s just kind of wrap things up a little bit with what is the eating life in the day of Dr. Joel Kahn. Give me two scenarios. One where you’re busy as can be and you don’t have much time, and the other where you can be a little more leisurely. What’s your typical breakfast?

Joel Kahn: I only relate to the first scenario. Unfortunately, but truly, without bragging. It’s not necessarily a good thing. I love what I do, but I do it too much.

I probably skip breakfast. I never skip coffee, because coffee is the solution. I have a problem. I wake up with lots of energy. I don’t need coffee for that. I just like good coffee – generally organic beans and such. Black coffee only. I don’t put anything in my coffee. I certainly don’t put butter or MCT oil in my coffee.

I’m coffee after workout. Typically, that’s it. I don’t really get hungry until noon. I bring lunch to work. I see cardiology patients five days a week. I bring it in a glass container. I don’t want plastics in my life. I work very hard to avoid all that. I don’t drink out of Styrofoam; I don’t drink out of plastic cups at restaurants. It’s got to be something better – glass bottles, stainless steel bottles.

Lunch will be a big salad with tempeh, with beans. I love sprouts. I could eat sprouts all day long. The fresher the better – pea sprouts, sunflower sprouts, broccoli sprouts, radish sprouts. The highest concentration of cancer-fighting chemicals in the plant world are found within broccoli sprouts – just a few times more than even broccoli. They’re much more abundant in grocery stores or you grow your own. It might be a gigantic soup.

I love spices. Spices are everywhere. Again, organic. I get Bragg’s spices. I don’t have any relationship with the Bragg’s [inaudible 00:34:47] family. I just like their spices. Spices are little dried plants, and they retain a lot of activity. Turmeric, Lotta spice, [inaudible 00:34:59]. I drink water and herbal tea, all day long after coffee – a lot of hibiscus tea. It’s very rich in antioxidants. Some green tea, some black tea, some ginger citrus tea.

Dinner – I own three restaurants – two in Detroit and a food truck in Austin, TX called ATX Food that I’ll be visiting in a couple of weeks. I’m going to have a pretty hardy plant-based meal. My home kitchen doesn’t do much anymore, because I have a restaurant that seats 100 people with skilled chefs. It’s totally plant based and original food. So it might be a black bean burger. Much more likely, I’m going to do our homemade black bean burger than an impossible burger. They are interesting. I still feel they have a ways to go before they call them healthy. It might be a macro bowl with some kimchi. Kimchi and our fermented, probiotic-rich foods, they’re always good. It might be a flatbread pizza.

I’m not gluten free by necessity. My wife has some sensitivities to gluten, so we eat a lot of gluten-free options and carry a lot in the restaurant. If I’m in New York and L.A., I’m going to the great restaurants that favor these whole food kind of farm-to-table plant choices.

As you said, again, I have a no investment in a website called HappyCow.net. But you can go to any city in the world and find out the healthier gourmet grocery stores, the healthier restaurants that favor whole food plant-based eating. There’s the word vegan and there’s the word whole food plant-based.

Vegan, was from its start, a wonderful, ethical movement in 1944 in England to avoid harming animals for ethical reasons. We should all embrace that as a laudable goal. It gets ridiculed a lot. A big, burly guy that won’t harm an animal out of compassion is a sexy guy. Obviously, it works for women too.

But the whole food plant based is what we talk about in the medical world. We’re not talking about a sloppy, fake burger with fake cheese with fake sauces with fake milkshakes. They’re delicious, but that’s not what I treat my patients with nor would I advise as a regular access to the plant-based world. It’s an interesting starting point. I used to eat fake bologna 30 years ago. I don’t eat that anymore.

Now, it’s transitioned to fake burgers, fake mac and cheese and all. They taste like the real thing and they’re great for the environment and they’re great for the animals, but this whole food plant based or when we joke around, we call it wif-a pib. We always say it fast because nobody knows what the heck you just said. A wif-a-pid diet is really the goal for many days a week, many meals a week, or exclusively.

Kathy Smith: What a great message. I like that approach, because it’s not judgmental. I find in these movements, everybody gets very judgmental of the other person whether you put an egg in your mouth or whether you’re putting all broccoli in your mouth. I think the idea is with plant based, which I have followed my entire life – some form of it. I think the confusion lies in how much – if you put a little protein in, if you have fish once a week, if you have a little dollop or a tablespoon of yogurt on top of your oatmeal once a week, those types of things that you add in that are pleasure, they taste good, you like it.

That’s where my confusion still lies. I will wrap up with this. I could talk to you forever. But even with the blue zones, I bought a magazine four months ago. National Geographic put it out. It was all the whole foods and it says the blue zone. So I buy it. I’ve read lots of books obviously on the blue zones, but one of the things they did there is they took graphs of all of the blue zone areas in the world – from the Loma Lindas to the Okinawas, from Italy to Greece. And they broke down their nutrients and their groups of foods. They were into plants, vegetables, fruits, grains, meat, fish, dairy, oil, fat, that sort of thing. It’s surprising, even though we say the blue zones are plant based and a lot of times a lot of people think that means vegetarian, all plants.

Okinawa still had 15% dairy, 5% fish. There were still little bits of this throughout all– including Loma Linda, which typically was the strictest as far as it relates to meat. But that’s where I think the confusion for me lies.

You’ve done a lot to clear it up today. I’m a big believer in eating a diet that’s going to help the planet, that’s going to help your body, that’s going to be sustainable. I agree that this is the way to go, and I think those areas that we’re still kind of working out will continue and we’ll continue having discussions on them.

Joel Kahn: I agree. Some would say 90% whole food plant based and 10% is your choice. Actually, that’s something that John Mackey, founder of the chain Whole Foods, teaches. He’s not a medical doctor, but he’s been in the world of health and sits with some of the leading health experts in the world. It’s very hard to argue.

I would say, again, I just would reserve the serious heart patient, maybe the patient actively trying to reverse type 2 diabetes, to do the research. Because most of those published, and really honored, research studies are whole food plant-based diets that are closer to 98%, 99%, 100%. But if you mess up today, get back on it tomorrow. As they say, every “bad meal” – I’m not judging – coupled with something good is a far better choice.  Because we’re lacking whole grains, fruits, vegetables, nuts, and seeds in our diet more than any other component of fixing our diet worldwide let alone in the United States.

You just keep on spreading the good word. I’ll keep on spreading the good word.

Kathy Smith: Okay. I don’t think you needed your M.D. degree. I think you needed to listen to your mother. You needed to just eat your vegetables and you would have been fine, I guess.

Thank you for all the good work. You’re such a doll, and I love listening to you. You’re helping so many people. So thank you so much.

Joel Kahn: God bless you and thank you for arranging this. It’s a joy.

Kathy Smith: Thanks, Joel. Bye-bye now.

Joel Kahn: Bye-bye.

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